SNAP CATI Client Survey

Study of the Effectiveness of Efforts to Improve Supplemental Nutrition Assistance Program Access Among Medicare's Extra Help Population Pilot Projects

Documents and Forms

Document Name Document Type
Appendix A - SNAP Extra Help CATI Client Survey.docx Other-Appendix A-SNAP Extra Help CAT
Appendix B - SNAP Extra Help CATI Client Survey_Spanish.docx Other-Appendix B-SNAP Extra Help CAT
Appendix H- Advance Letter Revised 10 12 12.docx Appendix H-Advance Letter IC Document
Appendix I - Locating Letter Revised 10 12 12.docx Appendix I-Locating Letter IC Document
Appendix J - ThankYou Letter Revised 10 12 12.docx Appendix J-Thank You Letter IC Document
Appendix K-Tribal Letter NM 10 12 12 .docx Appendix K-Tribal Letter to New Mexico IC Document
Appendix L - Tribal Letter WA 10 12 12 .docx Appendix L-Tribal Letter to Washington IC Document
Appendix M - Advance Letter_SPANISH_REVISED 10 12 12.docx Appendix M-Advance Letter-Spanish IC Document
Appendix N - Locating Letter_SPANISH 10 12 12.docx Appendix N-Locating Letter-Spanish IC Document
Appendix O - ThankYou Letter_SPANISH 10 12 12.docx Appendix O-Thank You Letter-Spanish IC Document

Information Collection (IC) Details

IC Title:	SNAP CATI Client Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix A-SNAP Extra Help CATI Client Survey			Appendix A - SNAP Extra Help CATI Client Survey.docx		Yes	No	Fillable Fileable
Other-Appendix B-SNAP Extra Help CATI Client Spanish Survey			Appendix B - SNAP Extra Help CATI Client Survey_Spanish.docx		Yes	No	Fillable Fileable

Line of Business: Income Security

Subfunction: Food and Nutrition Assistance

Privacy Act System of Records
Title: FNS-8 USDA/FNS Studies and Reports	FR Citation: 56 FR 19078

Number of Respondents: 4,803	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,803	4,803
Annual IC Time Burden (Hours)	1,729	1,729
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix H-Advance Letter	Appendix H- Advance Letter Revised 10 12 12.docx	10/15/2012
Appendix I-Locating Letter	Appendix I - Locating Letter Revised 10 12 12.docx	10/15/2012
Appendix J-Thank You Letter	Appendix J - ThankYou Letter Revised 10 12 12.docx	10/15/2012
Appendix K-Tribal Letter to New Mexico	Appendix K-Tribal Letter NM 10 12 12 .docx	10/15/2012
Appendix L-Tribal Letter to Washington	Appendix L - Tribal Letter WA 10 12 12 .docx	10/15/2012
Appendix M-Advance Letter-Spanish	Appendix M - Advance Letter_SPANISH_REVISED 10 12 12.docx	10/15/2012
Appendix N-Locating Letter-Spanish	Appendix N - Locating Letter_SPANISH 10 12 12.docx	10/15/2012
Appendix O-Thank You Letter-Spanish	Appendix O - ThankYou Letter_SPANISH 10 12 12.docx	10/15/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.